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Transurethral thermotherapy of the benign prostate hypertrophy controlled by radiometry
Abstract:
Up to now control of the microwave heating of the prostate was only possible with rectal or urethral surface catheters. This problem has finally been solved with the help of the Prostcare apparatus (Bruker Spectrospin, Wissembourg, France) and radiometry: the prostate can be treated by the urethral or endorectal route with a 915-MHz generator and coaxial antennae, a unique device which allows us to measure real intraprostatic temperature, to regulate the microwave emission power and to eliminate classic surface controls. A sole antenna is used for the urethral catheter; it is introduced within the Foley-type probe and allows us to heat and measure the heat (radiometry). In this preliminary report, we present clinical results of the first 105 treated patients over 18 months by the transurethral route in a single 1-hour session: 7 have a protuberant median lobe and the treatment is without any effect; 76 patients can be analyzed and the Madsen score before treatment, at 3 months and at 6 months moves from 11.2 to 2.5 and 3.1, the maximum flow rate from 9.6 to 12.3 and 12.5 ml/s, the residue decreases from 102 to 68 and 53 ml. The session is well tolerated and patients mention that the effects are better than those of medical treatment. Hyperthermia is a simple method that will find its place between medical and surgical treatment once the numerous randomized studies have determined the most suitable therapeutic procedures.